Garuda - Garba Rujukan Digital

Penyengatan Meningeal Sisterna Basalis Meningitis TB pada Computed Tomography Scanning: Sebuah Ulasan Bergambar Tjan, Anastasia; Asih, Made Widhi; Martadiani, Elysanti Dwi
Jurnal Ilmiah Kedokteran Wijaya Kusuma Vol 8, No 2 (2019): EDISI SEPTEMBER 2019 (available online since Oktober 2019)
Publisher : Universitas Wijaya Kusuma Surabaya

Tuberculosis (TB) is one of the major worldwide threat and global burden in Indonesia. CNS tuberculosis is the most severe form of TB infection. CT evaluation on diagnosing tuberculosis meningitis (TBM) with triad of hydrocephalus, basal meningeal enhancement and infarction was reported to be sensitive. PCR cerebrospinal fluid (CSF) is known to be specific, however negative results have been reported due to presence of PCR?s inhibitors, poor lysis of mycobacteria, and the uneven distribution in specimens. CT Scan plays the vital role in diagnosing TBM patient with the presence of TBM CT triad, especially basal cistern enhancement (BME) which is the specific enhancement pattern in MTB patient. There are 9 must know BME pattern, such as contrast filling the cistern, double and triple line, linear enhancement at MCA cistern, Y sign, posterior infundibular recess enhancement, ill defined border, join the dots sign, nodular enhancement, and asymmetry off all pattern. Familiarizing BME criteria is essential to provide confident diagnosis and reduce morbidity and mortality

Increase of Carotid Intima-Media Thickness and Reduction of Carotid Artery Lumen Diameter in Breast Cancer Patient Before and After Chemotherapy Inez Kartika; Made Widhi Asih; Elysanti Dwi Martadiani; Pande Putu Yuli Anandasari; Putu Patriawan; I Gde Raka Widiana
JBN (Jurnal Bedah Nasional) Vol 6 No 1 (2022): JBN (Jurnal Bedah Nasional)
Publisher : Program Studi Ilmu Bedah, Fakultas Kedokteran Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/JBN.2022.v06.i01.p02

Background: Increasing number of cancer survivor motivates clinical practitioner to focus on chronic effect of chemotherapy agent, especially those with vascular toxicity effect, which may attenuate the incidence of thrombosis and atherogenesis. Ultrasonography examination on carotid intima media thickness (C-IMT) provides acurate result in evaluating atherosclerotic. The purposes of this research are to find out any structural changes of carotid artery, especially atheroclerosis changes in breast cancer patient after chemoteraphy. Methods: Analytic cross sectional study using a pre post test group design in breast cancer patients. Eligible subjects undergo carotid ultrasonography examination prior to chemoteraphy and after they had completed the 3 cycles of chemoteraphy for the second exam. The examination was perfomed with the same USG machine, high frequency linier transducer (>7mHz) in B-mode under the auspecies of two reputable radiologist consultant. Results: Total patients are 26, mean of age (year) is 47.15 ± 8.11. Most dominant histopathology finding is invasive carcinoma nonspecific type, in 24 patients (92.4%) and the disease stage is in stadium III in 14 patients (53.9%). Mean C-IMT (mm) prior chemotherapy is 0.51 ± 0.06 and after chemotherapy is 0.58 ± 0.05, there is an increase of 0.07 ± 0.06 (p<0.0001). Carotid artery lumen diameter (mm) before chemotherapy is 4.05 ± 0.66 and after chemotherapy is 3.90 ± 0.73, so there is a decrease of 0.16 ± 0.40 (p =0.057). Conclusion: There is a statistically significant increase in intima media thickness of carotid wall of breast cancer patients after chemotherapy, consisted with chemoteraphy induced atherosclerosis.

Karakteristik temuan radiologis pada pasien low back pain di RSUP Sanglah Denpasar periode Maret 2016-Oktober 2017 Komang Mila Triana Sari; Elysanti Dwi Martadiani; Made Widhi Asih
Intisari Sains Medis Vol. 10 No. 1 (2019): (Available online 1 April 2019)
Publisher : DiscoverSys Inc.

Background: Low back pain (LBP) is a common problem in almost all parts of the world. It may cause disability and a huge social and economic burden in the community. Radiological examination is often necessary to help the doctor in evaluating LBP.Aim: The study aims to find out the radiological characteristics of LBP as a preventive effort against those case.Method: The study was descriptive cross-sectional design involved 65 LBP patients as study respondents in Sanglah General Hospital from March 2016-October 2017.Result: Characteristics of LBP patients are male patients and patients aged 50-59 years. Both are the most frequent sample which were found out in the study.Conclusion: The most common radiological findings in each examination modality are as follows: osteophytes on Radiographic examination, burst fracture, compression fracture and fractures of spinous process on CT scan, and spinal canal stenosis on MRI examination.

The correlation between location and size of infarction toward the quality of life in acute ischemic stroke patients at Sanglah General Hospital, Bali, Indonesia Mirani Ulfa Yusrika; Anak Agung Bagus Ngurah Nuartha; Ida Ayu Sri Wijayanti; Made Widhi Asih; Skolastika Savitri Sujatmiko
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Background: Location and size of infarction in acute ischemic stroke can cause different levels of neurological deficits and disabilities according to the function of the area of brain whose blood flow is disrupted, thus affecting the quality of life in patients. This study was aimed to explore the correlation between location and size of infarction toward the quality of life in acute ischemic stroke patients in Sanglahà¹€Generalà¹€Hospitalà¹€Denpasar.Methods: A cross-sectional study was conducted among 41 acute ischemic stroke patients at Neurologyà¹€Care Unit, Sanglahà¹€General Hospital Denpasar duringà¹€May-September 2019. The location of the infarct was grouped by the cerebral area. The largest diameter of infarction determined the size of the infarct. Data were taken from head Computedà¹€Tomography (CT) scan results to assess the location and size of infarction and Barthel Index (BI) to measure the quality of life-based on Activity of Daily Living (ADL). Data were analyzed using univariate and bivariate analysisà¹€(Chi-Squareà¹€testà¹€withà¹€Cramerâ€™sà¹€V for location and BI scores, Spearmanà¹€test for size and BI scores) on SPSSà¹€version 23 for Windows.Results: Most of the respondents were males 59.0%, the average age of 60.03Â±14.4 years, ischemic thrombus stroke (71.8%), subcortical infarction (41.0%), small size (â‰¤ 1.5 cm) of infarction (48.7%), and independent criteria for Barthel Index Scores (23.1%). There were significant correlations between the location of infarction and BI scores (r=0.636; p<0.000) and the size of infarction and BI scores (r=0.553; p<0.000).Conclusion: Infarct that located in the cortical area with small size are related to independent or mild dependency outcome. Conversely, infarct that located and associated with a subcortical area with larger size are related to severe or total dependency.

Gambaran radiologi lesi litik pada manus: serial kasus Jessica Harlan; Elysanti Dwi Martadiani; Made Widhi Asih; I Wayan Juli Sumadi
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Background: Lytic lesion of the hand has been challenging in making the differential diagnoses. Tumor and tumor-like lesions present with a wide spectrum of radiological changes.Cases: The first patient is a 17 years old male presents with a painless lump in the left 5th finger, suggested as benign bone tumor. The second patient is a 28 years old male presents with a painful lump in the left 3rd finger,suggested as close fracture of the left metacarpal of the hand. The third patient is a 11 years old male presents with a painless lump and open wound in the right 2nd finger,suggested as aggressive bone tumor. First patient‘s hand radiographs reveal expansile lytic lesions with narrow transitional zone, endosteal scaloping, ring and arc calcification, no perisoteal reaction, no cortical destruction in metadiaphysis of 5th metacarpal and proximal phalanx of the left hand, suggested as primary benign bone tumor, suggested enchondroma. Histomorphology result suggested as enchondromatosis. Second patient‘s hand radiographs reveal expansile lytic lesion with narrow transitional zone and cortical destruction, no periosteal reaction, no calcification in epiphysis to diaphysis of 3rd proximal phalanx of the left hand, suggested as primary benign bone tumor, suggested giant cell tumor. Histomorphology result suggested as benign giant cell tumors of the bone. Third patient’s hand radiographs reveal fusiform expansile lytic lesion with narrow transitional zone causes enlargement of diaphysis with cortical destruction and soft tissue mass, no periosteal reaction, no calcification in 2nd proximal phalanx of right hand, suggested as tuberculous dactylitis, suggested non tuberculous osteomyelitis. Histomorphology result suggested as tuberculous process.Conclusion: Imaging and histomorphology play an important role in differentiating tumor and tumor-like lesions in bone. Recognition of imaging appearance of these lesions may help clinicians make a decision for the treatment. Latar Belakang: Lesi osteolitik pada manus menjadi tantangan dalam membuat diagnosis banding. Tumor dan lesi yang menyerupai memiliki gambaran radiologi beragam.Kasus: Pasien pertama laki-laki usia 17 tahun dengan keluhan benjolan yang tidak nyeri pada jari ke 5 tangan kiri dengan kecurigaan tumor tulang jinak. Pasien kedua laki-laki usia 28 tahun dengan keluhan benjolan yang nyeri pada jari ke 3 tangan kiri dengan kecurigaan fraktur tertutup pada metacarpal tangan kiri. Pasien ketiga laki-laki usia 11 tahun dengan keluhan benjolan disertai luka terbuka pada jari ke 2 tangan kanan dengan kecurigaan tumor tulang agresif. Radiografi manus pasien pertama mengesankan lesi litik ekspansil dengan narrow transitional zone pada metadiafisis metacarpal digiti V dan phalang proksimal digiti V manus kiri dengan endosteal scalopping, tidak tampak reaksi perisoteal maupun destruksi korteks, matriks kalsifikasi ring and arc yang mengesankan tumor tulang primer jinak, mengesankan enchondroma. Histomorfologi sesuai gambaran enchondromatosis. Radiografi manus pasien kedua mengesankan lesi litik ekspansil dengan narrow transitional zone yang menyebabkan destruksi korteks pada epifisis hingga diafisis phalang proksimal digiti III manus kiri dengan keterlibatan jaringan lunak, tidak tampak matriks kalsifikasi maupun reaksi periosteal yang mengesankan gambaran giant cell tumor. Histomorfologi sesuai gambaran giant cell tumor tulang jinak. Radiografi manus pasien ketiga mengesankan lesi litik ekspansil fusiform dengan narrow trazitional zone yang menyebabkan pelebaran diafisis dengan destruksi korteks dan keterlibatan jaringan lunak pada phalang proksimal digiti II manus kanan, tidak tampak matriks kalsifikasi maupun reaksi periosteal yang mengesankan suatu daktilitis tuberkulosis dengan diagnosis banding osteomyelitis non tuberkulosis. Histomorfologi sesuai gambaran tuberculosis. Simpulan: Pencitraan dan histomorfologi memainkan peran penting dalam membedakan tumor dan lesi yang menyerupai tumor pada tulang. Mengenali lesi ini sangat penting karena membantu klinisi untuk menentukan terapi.

Kimura's disease: a neoplasm mimicking, a rare benign form of chronic inflammatory disorder Harley Septian; Made Widhi Asih; Nyoman Srie Laksminingsih; Anak Agung Ayu Ngurah Susraini
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Background: Kimura's Disease (KD) is a benign, rare form of chronic inflammatory disease of unknown origin, almost exclusively found in Asian males in their second to fourth decades of life. This rare condition is mostly present as soft tissue mass consists of multiple painless solitary subcutaneous nodules mostly localized in the head and neck region, with coexisting lymph node enlargement and eosinophilia. This case study aims to describe Kimura's Disease (KD) characteristics and give an insight into the role of Computed Tomography (CT) scan in identifying KD and its imaging characteristics.Case Presentation: We reported a case of an Asian man with a history of 18 years left-sided painless facial mass, gradually increase in size with no history of hoarseness, epistaxis, previous facial mass or malignancy, and familial malignancy. CT scan findings showed an inhomogeneous contrast enhancement soft tissue mass located on the left parotid-submandibular region with multiple neck lymphadenopathy and left parotid gland involvement. Eosinophilia was found persistently in the laboratory outcomes, and this mass had been confirmed with histological findings consistent with KD features.Conclusion: Recognizing the characteristics of KD and the imaging findings on Ultrasound and CT-scan as accessible and first-line diagnostic tools, might help in facilitating the diagnosis, making a decision and sparing the patient from unnecessary and harmful procedures.

Penyengatan Meningeal Sisterna Basalis Meningitis TB pada Computed Tomography Scanning: Sebuah Ulasan Bergambar Anastasia Tjan; Made Widhi Asih; Elysanti Dwi Martadiani
Jurnal Ilmiah Kedokteran Wijaya Kusuma Vol 8, No 2 (2019): EDISI SEPTEMBER 2019 (available online since Oktober 2019)
Publisher : Universitas Wijaya Kusuma Surabaya

Tuberculosis (TB) is one of the major worldwide threat and global burden in Indonesia. CNS tuberculosis is the most severe form of TB infection. CT evaluation on diagnosing tuberculosis meningitis (TBM) with triad of hydrocephalus, basal meningeal enhancement and infarction was reported to be sensitive. PCR cerebrospinal fluid (CSF) is known to be specific, however negative results have been reported due to presence of PCR’s inhibitors, poor lysis of mycobacteria, and the uneven distribution in specimens. CT Scan plays the vital role in diagnosing TBM patient with the presence of TBM CT triad, especially basal cistern enhancement (BME) which is the specific enhancement pattern in MTB patient. There are 9 must know BME pattern, such as contrast filling the cistern, double and triple line, linear enhancement at MCA cistern, Y sign, posterior infundibular recess enhancement, ill defined border, join the dots sign, nodular enhancement, and asymmetry off all pattern. Familiarizing BME criteria is essential to provide confident diagnosis and reduce morbidity and mortality

KORELASI ASPECT SCORE DENGAN NIHSS, GCS, DAN LAMA DIRAWAT PADA PASIEN STROKE NON HEMORAGIK AKUT DI RSUP SANGLAH Juniada, Putu Herry; Asih, Made Widhi; Margiani, Ni Nyoman; Eka Putra, I Wayan Gede Artawan; Mahendra Wijaya, I Gusti Agung Gede
E-Jurnal Medika Udayana Vol 11 No 12 (2022): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2022.V11.i12.P01

Stroke adalah kondisi medis mengancam nyawa, akibat terputusnya pasokan darah ke bagian otak tertentu, bisa diakibatkan oleh pembuluh darah otak yang pecah (stroke hemoragik), maupun tersumbat (stroke non hemoragik). Stroke Non Hemoragik (SNH) membutuhkan penanganan segera dengan terapi trombolisis (IV-rtPA) dalam 3-4,5 jam pasca awitan SNH untuk menurunkan angka morbiditas dan mortalitas. Salah satu metode penilaian kelayakan pasien SNH (melalui pencitraan otak) untuk menerima terapi trombolisis adalah dengan ASPECT Score. Namun IV-rtPA dan ASPECT Score masih sangat jarang diterapkan karena berbagai faktor, sehingga untuk saat ini kami memiliki gagasan untuk meneliti bagaimana korelasi ASPECT Score dengan NIHSS, GCS, dan lama dirawat pada pasien SNH akut. Harapannya dapat ikut mempromosikan ASPECT Score, agar semua stakeholder lebih akrab dengan ASPECT Score jika sudah siap dengan terapi IV-rtPA nantinya. Penelitian ini adalah penelitian observasional analitik dengan pendekatan cross-sectional prospektif. Pasien SNH yang masuk IGD RSUP Sanglah pada bulan Oktober 2021 – Januari 2022 yang memenuhi kriteria inklusi dan eksklusi dipilih secara consecutive sampling sebanyak 66 sampel. Hasil pemeriksaan CT scan kepala tanpa kontras diambil dari PACS dan dilakukan penilaian ASPECT Score oleh 2 orang radiolog secara terpisah. Terdapat Interobserver Agreement penilaian ASPECT Score yang tinggi dan bermakna antara observer 1 dan 2 (r = 0,905; p = 0,00; 95% Limits of Agreement = -1,161 – 0,889). Namun ternyata tidak terdapat korelasi yang bermakna antara ASPECT Score dengan NIHSS, GCS, dan lama dirawat, yaitu dengan nilai r dan p masing-masing adalah r = -0,144, p = 0,250; r = 0,069, p = 0,584; dan r = -0,111, p = 0,375. Perlu dilakukan perbaikan design penelitian, contohnya dengan pendekatan longitudinal untuk mengakomodasi progresivitas infark, dan dengan membandingkan antara penilaian ASPECT Score melalui pemeriksaan CT scan dengan MRI (DWI) yang dikenal lebih sensitif dalam mengidentifikasi perubahan iskemik tahap awal. Kata kunci : ASPECT Score., NIHSS., GCS

KORELASI ASPECT SCORE DENGAN NIHSS, GCS, DAN LAMA DIRAWAT PADA PASIEN STROKE NON HEMORAGIK AKUT DI RSUP SANGLAH Juniada, Putu Herry; Asih, Made Widhi; Margiani, Ni Nyoman; Eka Putra, I Wayan Gede Artawan; Martadiani, Elysanti Dwi; Mahendra Wijaya, I Gusti Agung Gede
E-Jurnal Medika Udayana Vol 11 No 10 (2022): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2022.V11.i10.P02

Stroke adalah kondisi medis mengancam nyawa, akibat terputusnya pasokan darah ke bagian otak tertentu, bisa diakibatkan oleh pembuluh darah otak yang pecah (stroke hemoragik), maupun tersumbat (stroke non hemoragik). Stroke Non Hemoragik (SNH) membutuhkan penanganan segera dengan terapi trombolisis (IV-rtPA) dalam 3-4,5 jam pasca awitan SNH untuk menurunkan angka morbiditas dan mortalitas. Salah satu metode penilaian kelayakan pasien SNH (melalui pencitraan otak) untuk menerima terapi trombolisis adalah dengan ASPECT Score. Namun IV-rtPA dan ASPECT Score masih sangat jarang diterapkan karena berbagai faktor, sehingga untuk saat ini kami memiliki gagasan untuk meneliti bagaimana korelasi ASPECT Score dengan NIHSS, GCS, dan lama dirawat pada pasien SNH akut. Harapannya dapat ikut mempromosikan ASPECT Score, agar semua stakeholder lebih akrab dengan ASPECT Score jika sudah siap dengan terapi IV-rtPA nantinya. Penelitian ini adalah penelitian observasional analitik dengan pendekatan cross-sectional prospektif. Pasien SNH yang masuk IGD RSUP Sanglah pada bulan Oktober 2021 – Januari 2022 yang memenuhi kriteria inklusi dan eksklusi dipilih secara consecutive sampling sebanyak 66 sampel. Hasil pemeriksaan CT scan kepala tanpa kontras diambil dari PACS dan dilakukan penilaian ASPECT Score oleh 2 orang radiolog secara terpisah. Terdapat Interobserver Agreement penilaian ASPECT Score yang tinggi dan bermakna antara observer 1 dan 2 (r = 0,905; p = 0,00; 95% Limits of Agreement = -1,161 – 0,889). Namun ternyata tidak terdapat korelasi yang bermakna antara ASPECT Score dengan NIHSS, GCS, dan lama dirawat, yaitu dengan nilai r dan p masing-masing adalah r = -0,144, p = 0,250; r = 0,069, p = 0,584; dan r = -0,111, p = 0,375. Perlu dilakukan perbaikan design penelitian, contohnya dengan pendekatan longitudinal untuk mengakomodasi progresivitas infark, dan dengan membandingkan antara penilaian ASPECT Score melalui pemeriksaan CT scan dengan MRI (DWI) yang dikenal lebih sensitif dalam mengidentifikasi perubahan iskemik tahap awal. Kata kunci : ASPECT Score, NIHSS, GCS

HUBUNGAN ANTARA SKOR KELAINAN ANATOMI SINUS PARANASAL DAN KAVUM NASI DENGAN SINUSITIS PARANASAL MENURUT GAMBARAN CT-SCAN SINUS PARANASAL PADA PASIEN DENGAN KLINIS SINUSITIS Maria, Dessy; Asih, Made Widhi; Margiani, Ni Nyoman; Widiana, I Gede Raka; Patriawan, Putu; Laksminingsih, Nyoman Srie
E-Jurnal Medika Udayana Vol 11 No 5 (2022): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2022.V11.i05.P10

Sinusitis adalah proses peradangan dari satu atau lebih pada membran mukosa sinus paranasal. Penyebab utama terjadinya sinusitis adalah gangguan drainase dan patensi kompleks ostiomeatal (KOM). Variasi anatomi hidung dan sinus paranasalis menjadi faktor predisposisi terhadap kejadian sinusitis. Tujuan penelitian adalah menilai hubungan antara skor kelainan anatomi sinus paranasal dan kavum nasi dengan sinusitis paranasal menurut gambaran CT-scan sinus paranasal pada pasien dengan klinis sinusitis. Penelitian ini dirancang sebagai penelitian observasional analitik dengan pendekatan cross sectional retrospektif pada pasien dengan klinis sinusitis di RSUP Sanglah Denpasar pada tahun 2020-2021. Sampel penelitian berjumlah 60 orang dengan usia di atas 21 tahun yang diambil secara consecutive sampling dari rekam medis yang memenuhi kriteria inklusi. Analisis sinusitis dan skor kelainan anatomi sinus paranasal dan kavum nasi masing-masing dilakukan oleh seorang Radiolog Konsultan dilanjutkan dengan analisis data. Dari hasil uji beda proporsi antara kelainan anatomi sinus paranasal dan kavum nasi dengan sinusitis maupun antara skor kelainan anatomi sinus paranasal dan kavum nasi dengan sinusitis didapatkan tidak ada hubungan dengan nilai p>0,05. Pada hasil uji korelasi multivariat antara skor kelainan anatomi sinus paranasal dan kavum nasi dengan sinusitis setelah dikontrol dengan umur, jenis kelamin dan riwayat alergi secara statistik tampak tidak berhubungan dengan nilai p yang didapat semuanya >0,05. Tidak tampak korelasi antara skor kelainan anatomi sinus paranasal dan kavum nasi dengan sinusitis menurut gambaran CT-scan sinus paranasal pada pasien dengan klinis sinusitis dengan nilai p 0,105. Masih diperlukan perbaikan metode penelitian lebih lanjut dengan desain penelitian analitik menggunakan rancangan prospektif.

Title

Found 14 Documents
Search

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Title Search

Found 14 Documents Search

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Title

Found 14 Documents
Search